title: Inter-observer reproducibility of probing to bone in the diagnosis of diabetic foot osteomyelitis.
abstract: OBJECTIVE
  The objectives of our study were (i) to analyse the inter-observer reproducibility or diagnostic variability of the probing-to-bone test, depending on the training of the professional involved, and (ii) to assess whether the probing-to-bone test can be extrapolated to any professional specialty that deals with these patients.
  
  
  METHODS
  This was a cross-sectional study, involving 75 patients with diabetic foot ulcer and clinical suspicion of osteomyelitis. A registration sheet was completed for all patients involved in the research study, gathering data relative to the results of the probing-to-bone test performed by three observers. Observer 1 was a very experienced professional with several years of experience in the treatment of the diabetic foot; observer 2 was a medium-experienced professional whose experience ranges from 6 to 12 months in the treatment of the diabetic foot; observer 3 was a healthcare professional without experience in the treatment of the diabetic foot. Data were gathered confidentially by a fourth researcher.
  
  
  RESULTS
  The results showed a kappa index of 0.593 (95% CI 0.407-0.778) between observer 1 and observer 2, 0.397 (95% CI 0.188-0.604) between observer 1 and observer 3 and 0.53 (95% CI 0.335-0.725) between observer 2 and observer 3.
  
  
  CONCLUSIONS
  The probing-to-bone test demonstrated moderate to fair concordance with an experienced examiner, although the degree of concordance is not significant between groups.
authors.affiliation: Diabetic Foot Unit, University Podiatric Clinic, College of Podiatry, Complutense University of Madrid, Madrid, Spain. esthergarciamorales@yahoo.es
authors.forename: E
authors.initials: E
authors.lastname: García Morales
authors.forename: J L
authors.initials: JL
authors.lastname: Lázaro-Martínez
authors.forename: F J
authors.initials: FJ
authors.lastname: Aragón-Sánchez
authors.forename: A
authors.initials: A
authors.lastname: Cecilia-Matilla
authors.forename: J V
authors.initials: JV
authors.lastname: Beneit-Montesinos
authors.forename: M A
authors.initials: MA
authors.lastname: González Jurado
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D001842:Bone and Bones / Q000473:pathology*; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000473:pathology*; D003925:Diabetic Angiopathies / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D017719:Diabetic Foot / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D010019:Osteomyelitis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results